|
SSB to TheraTest
|
Facility
|
IP
|
$54.00
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
2778833
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$27.52 |
| Max. Negotiated Rate |
$51.67 |
| Rate for Payer: Aetna Commercial |
$50.54
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$48.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$29.76
|
| Rate for Payer: Cash Price |
$16.20
|
| Rate for Payer: Cigna Commercial |
$51.67
|
| Rate for Payer: Health EOS Commercial |
$49.98
|
| Rate for Payer: HFN Commercial |
$51.67
|
| Rate for Payer: Multiplan Commercial |
$44.93
|
| Rate for Payer: Preferred Network Access Commercial |
$51.67
|
| Rate for Payer: Quartz Beloit One Network |
$27.52
|
| Rate for Payer: Quartz Commercial |
$33.70
|
| Rate for Payer: WEA Trust Commercial |
$30.89
|
| Rate for Payer: WPS Commercial |
$41.60
|
|
|
SSB to TheraTest
|
Facility
|
OP
|
$54.00
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
2778833
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$18.65 |
| Max. Negotiated Rate |
$74.59 |
| Rate for Payer: Aetna Commercial |
$50.54
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$48.30
|
| Rate for Payer: Aetna Managed Medicare |
$18.65
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$69.93
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$32.63
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$30.95
|
| Rate for Payer: Anthem Medicare Advantage |
$18.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$29.76
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$18.65
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$18.65
|
| Rate for Payer: Cash Price |
$16.20
|
| Rate for Payer: Cash Price |
$16.20
|
| Rate for Payer: Cigna Commercial |
$51.67
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$18.65
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$31.43
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$18.65
|
| Rate for Payer: Health EOS Commercial |
$49.98
|
| Rate for Payer: HFN Commercial |
$51.67
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$69.37
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$18.65
|
| Rate for Payer: Independent Care Health Plan Medicare |
$18.65
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$18.65
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$18.65
|
| Rate for Payer: Multiplan Commercial |
$44.93
|
| Rate for Payer: NAPHCARE Commercial |
$27.97
|
| Rate for Payer: Preferred Network Access Commercial |
$51.67
|
| Rate for Payer: Quartz Beloit One Network |
$27.52
|
| Rate for Payer: Quartz Commercial |
$36.50
|
| Rate for Payer: Quartz Medicare Advantage |
$18.65
|
| Rate for Payer: The Alliance Commercial |
$74.59
|
| Rate for Payer: United Healthcare Medicare Advantage |
$18.65
|
| Rate for Payer: United Healthcare PPO |
$42.12
|
| Rate for Payer: WEA Trust Commercial |
$30.89
|
| Rate for Payer: Wellcare Medicare |
$18.65
|
| Rate for Payer: WPS Commercial |
$41.60
|
|
|
ssDNA to TheraTest
|
Professional
|
Both
|
$54.00
|
|
|
Service Code
|
CPT 86226
|
| Hospital Charge Code |
2778834
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$12.59 |
| Max. Negotiated Rate |
$55.42 |
| Rate for Payer: Aetna Commercial |
$53.35
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$48.30
|
| Rate for Payer: Aetna Managed Medicare |
$12.59
|
| Rate for Payer: Anthem Medicare Advantage |
$12.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$12.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$12.59
|
| Rate for Payer: Cash Price |
$16.20
|
| Rate for Payer: Cash Price |
$16.20
|
| Rate for Payer: Cigna Commercial |
$53.35
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$28.08
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$12.59
|
| Rate for Payer: Health EOS Commercial |
$51.11
|
| Rate for Payer: HFN Commercial |
$53.35
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$44.46
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$44.46
|
| Rate for Payer: Independent Care Health Plan Medicare |
$12.59
|
| Rate for Payer: Multiplan Commercial |
$44.93
|
| Rate for Payer: NAPHCARE Commercial |
$18.89
|
| Rate for Payer: Preferred Network Access Commercial |
$53.35
|
| Rate for Payer: Quartz Beloit One Network |
$24.71
|
| Rate for Payer: Quartz Commercial |
$32.01
|
| Rate for Payer: Quartz Medicare Advantage |
$12.59
|
| Rate for Payer: The Alliance Commercial |
$49.75
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12.59
|
| Rate for Payer: WEA Trust Commercial |
$30.89
|
| Rate for Payer: WPS Commercial |
$55.42
|
|
|
ssDNA to TheraTest
|
Facility
|
OP
|
$54.00
|
|
|
Service Code
|
CPT 86226
|
| Hospital Charge Code |
2778834
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$12.59 |
| Max. Negotiated Rate |
$51.67 |
| Rate for Payer: Aetna Commercial |
$50.54
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$48.30
|
| Rate for Payer: Aetna Managed Medicare |
$12.59
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$47.23
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$22.04
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$20.91
|
| Rate for Payer: Anthem Medicare Advantage |
$12.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$29.76
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$12.59
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$12.59
|
| Rate for Payer: Cash Price |
$16.20
|
| Rate for Payer: Cash Price |
$16.20
|
| Rate for Payer: Cigna Commercial |
$51.67
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$12.59
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$31.43
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$12.59
|
| Rate for Payer: Health EOS Commercial |
$49.98
|
| Rate for Payer: HFN Commercial |
$51.67
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$46.85
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$12.59
|
| Rate for Payer: Independent Care Health Plan Medicare |
$12.59
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$12.59
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$12.59
|
| Rate for Payer: Multiplan Commercial |
$44.93
|
| Rate for Payer: NAPHCARE Commercial |
$18.89
|
| Rate for Payer: Preferred Network Access Commercial |
$51.67
|
| Rate for Payer: Quartz Beloit One Network |
$27.52
|
| Rate for Payer: Quartz Commercial |
$36.50
|
| Rate for Payer: Quartz Medicare Advantage |
$12.59
|
| Rate for Payer: The Alliance Commercial |
$50.38
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12.59
|
| Rate for Payer: United Healthcare PPO |
$42.12
|
| Rate for Payer: WEA Trust Commercial |
$30.89
|
| Rate for Payer: Wellcare Medicare |
$12.59
|
| Rate for Payer: WPS Commercial |
$41.60
|
|
|
ssDNA to TheraTest
|
Facility
|
IP
|
$54.00
|
|
|
Service Code
|
CPT 86226
|
| Hospital Charge Code |
2778834
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$27.52 |
| Max. Negotiated Rate |
$51.67 |
| Rate for Payer: Aetna Commercial |
$50.54
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$48.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$29.76
|
| Rate for Payer: Cash Price |
$16.20
|
| Rate for Payer: Cigna Commercial |
$51.67
|
| Rate for Payer: Health EOS Commercial |
$49.98
|
| Rate for Payer: HFN Commercial |
$51.67
|
| Rate for Payer: Multiplan Commercial |
$44.93
|
| Rate for Payer: Preferred Network Access Commercial |
$51.67
|
| Rate for Payer: Quartz Beloit One Network |
$27.52
|
| Rate for Payer: Quartz Commercial |
$33.70
|
| Rate for Payer: WEA Trust Commercial |
$30.89
|
| Rate for Payer: WPS Commercial |
$41.60
|
|
|
STABILIZER EZ 9066
|
Facility
|
OP
|
$121.00
|
|
| Hospital Charge Code |
2975062
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$35.24 |
| Max. Negotiated Rate |
$115.77 |
| Rate for Payer: Aetna Commercial |
$113.26
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$108.22
|
| Rate for Payer: Aetna Managed Medicare |
$35.24
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$81.80
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$62.92
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$60.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$66.70
|
| Rate for Payer: Cash Price |
$36.30
|
| Rate for Payer: Cigna Commercial |
$115.77
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$70.42
|
| Rate for Payer: Health EOS Commercial |
$112.00
|
| Rate for Payer: HFN Commercial |
$115.77
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$94.38
|
| Rate for Payer: Multiplan Commercial |
$100.67
|
| Rate for Payer: NAPHCARE Commercial |
$75.50
|
| Rate for Payer: Preferred Network Access Commercial |
$115.77
|
| Rate for Payer: Quartz Beloit One Network |
$61.66
|
| Rate for Payer: Quartz Commercial |
$81.80
|
| Rate for Payer: Quartz Medicare Advantage |
$75.50
|
| Rate for Payer: The Alliance Commercial |
$62.92
|
| Rate for Payer: WEA Trust Commercial |
$69.21
|
| Rate for Payer: WPS Commercial |
$93.21
|
|
|
STABILIZER EZ 9066
|
Facility
|
IP
|
$121.00
|
|
| Hospital Charge Code |
2975062
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$61.66 |
| Max. Negotiated Rate |
$115.77 |
| Rate for Payer: Aetna Commercial |
$113.26
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$108.22
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$66.70
|
| Rate for Payer: Cash Price |
$36.30
|
| Rate for Payer: Cigna Commercial |
$115.77
|
| Rate for Payer: Health EOS Commercial |
$112.00
|
| Rate for Payer: HFN Commercial |
$115.77
|
| Rate for Payer: Multiplan Commercial |
$100.67
|
| Rate for Payer: Preferred Network Access Commercial |
$115.77
|
| Rate for Payer: Quartz Beloit One Network |
$61.66
|
| Rate for Payer: Quartz Commercial |
$75.50
|
| Rate for Payer: WEA Trust Commercial |
$69.21
|
| Rate for Payer: WPS Commercial |
$93.21
|
|
|
STABILIZER OCTOPUS EVOLUTION TS2500
|
Facility
|
IP
|
$6,709.00
|
|
| Hospital Charge Code |
4017903
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,418.91 |
| Max. Negotiated Rate |
$6,419.17 |
| Rate for Payer: Aetna Commercial |
$6,279.62
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,000.53
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,698.00
|
| Rate for Payer: Cash Price |
$2,012.70
|
| Rate for Payer: Cigna Commercial |
$6,419.17
|
| Rate for Payer: Health EOS Commercial |
$6,209.85
|
| Rate for Payer: HFN Commercial |
$6,419.17
|
| Rate for Payer: Multiplan Commercial |
$5,581.89
|
| Rate for Payer: Preferred Network Access Commercial |
$6,419.17
|
| Rate for Payer: Quartz Beloit One Network |
$3,418.91
|
| Rate for Payer: Quartz Commercial |
$4,186.42
|
| Rate for Payer: WEA Trust Commercial |
$3,837.55
|
| Rate for Payer: WPS Commercial |
$5,167.94
|
|
|
STABILIZER OCTOPUS EVOLUTION TS2500
|
Facility
|
OP
|
$6,709.00
|
|
| Hospital Charge Code |
4017903
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,953.66 |
| Max. Negotiated Rate |
$6,419.17 |
| Rate for Payer: Aetna Commercial |
$6,279.62
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,000.53
|
| Rate for Payer: Aetna Managed Medicare |
$1,953.66
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$4,535.28
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$3,488.68
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$3,349.13
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,698.00
|
| Rate for Payer: Cash Price |
$2,012.70
|
| Rate for Payer: Cigna Commercial |
$6,419.17
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3,904.64
|
| Rate for Payer: Health EOS Commercial |
$6,209.85
|
| Rate for Payer: HFN Commercial |
$6,419.17
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$5,233.02
|
| Rate for Payer: Multiplan Commercial |
$5,581.89
|
| Rate for Payer: NAPHCARE Commercial |
$4,186.42
|
| Rate for Payer: Preferred Network Access Commercial |
$6,419.17
|
| Rate for Payer: Quartz Beloit One Network |
$3,418.91
|
| Rate for Payer: Quartz Commercial |
$4,535.28
|
| Rate for Payer: Quartz Medicare Advantage |
$4,186.42
|
| Rate for Payer: The Alliance Commercial |
$3,488.68
|
| Rate for Payer: WEA Trust Commercial |
$3,837.55
|
| Rate for Payer: WPS Commercial |
$5,167.94
|
|
|
STABLESOFT 2S ATTACHMENT T401212S
|
Facility
|
OP
|
$3,056.00
|
|
| Hospital Charge Code |
2967353
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$889.91 |
| Max. Negotiated Rate |
$2,923.98 |
| Rate for Payer: Aetna Commercial |
$2,860.42
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,733.29
|
| Rate for Payer: Aetna Managed Medicare |
$889.91
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,065.86
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,589.12
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,525.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,684.47
|
| Rate for Payer: Cash Price |
$916.80
|
| Rate for Payer: Cigna Commercial |
$2,923.98
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,778.59
|
| Rate for Payer: Health EOS Commercial |
$2,828.63
|
| Rate for Payer: HFN Commercial |
$2,923.98
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,383.68
|
| Rate for Payer: Multiplan Commercial |
$2,542.59
|
| Rate for Payer: NAPHCARE Commercial |
$1,906.94
|
| Rate for Payer: Preferred Network Access Commercial |
$2,923.98
|
| Rate for Payer: Quartz Beloit One Network |
$1,557.34
|
| Rate for Payer: Quartz Commercial |
$2,065.86
|
| Rate for Payer: Quartz Medicare Advantage |
$1,906.94
|
| Rate for Payer: The Alliance Commercial |
$1,589.12
|
| Rate for Payer: WEA Trust Commercial |
$1,748.03
|
| Rate for Payer: WPS Commercial |
$2,354.04
|
|
|
STABLESOFT 2S ATTACHMENT T401212S
|
Facility
|
IP
|
$3,056.00
|
|
| Hospital Charge Code |
2967353
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,557.34 |
| Max. Negotiated Rate |
$2,923.98 |
| Rate for Payer: Aetna Commercial |
$2,860.42
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,733.29
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,684.47
|
| Rate for Payer: Cash Price |
$916.80
|
| Rate for Payer: Cigna Commercial |
$2,923.98
|
| Rate for Payer: Health EOS Commercial |
$2,828.63
|
| Rate for Payer: HFN Commercial |
$2,923.98
|
| Rate for Payer: Multiplan Commercial |
$2,542.59
|
| Rate for Payer: Preferred Network Access Commercial |
$2,923.98
|
| Rate for Payer: Quartz Beloit One Network |
$1,557.34
|
| Rate for Payer: Quartz Commercial |
$1,906.94
|
| Rate for Payer: WEA Trust Commercial |
$1,748.03
|
| Rate for Payer: WPS Commercial |
$2,354.04
|
|
|
STAB PHLEBECTOMY OF VARICOSE VEINS, 1 EXTREMITY; 10-20 STAB INCISIONS
|
Facility
|
OP
|
$13,291.62
|
|
|
Service Code
|
CPT 37765
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,322.90 |
| Max. Negotiated Rate |
$13,291.62 |
| Rate for Payer: Aetna Managed Medicare |
$3,322.90
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$10,303.28
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$8,364.72
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$7,944.56
|
| Rate for Payer: Anthem Medicare Advantage |
$3,322.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,322.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,322.90
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,322.90
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6,807.99
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,322.90
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$12,361.20
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,322.90
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,322.90
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,322.90
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,322.90
|
| Rate for Payer: NAPHCARE Commercial |
$4,984.36
|
| Rate for Payer: Quartz Medicare Advantage |
$3,322.90
|
| Rate for Payer: The Alliance Commercial |
$13,291.62
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,322.90
|
| Rate for Payer: United Healthcare PPO |
$4,267.12
|
| Rate for Payer: Wellcare Medicare |
$3,322.90
|
|
|
STAB PHLEBECTOMY OF VARICOSE VEINS, 1 EXTREMITY; MORE THAN 20 INCISIONS
|
Facility
|
OP
|
$13,291.62
|
|
|
Service Code
|
CPT 37766
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,322.90 |
| Max. Negotiated Rate |
$13,291.62 |
| Rate for Payer: Aetna Managed Medicare |
$3,322.90
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$10,303.28
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$8,364.72
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$7,944.56
|
| Rate for Payer: Anthem Medicare Advantage |
$3,322.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,322.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,322.90
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,322.90
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$6,807.99
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,322.90
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$12,361.20
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,322.90
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,322.90
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,322.90
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,322.90
|
| Rate for Payer: NAPHCARE Commercial |
$4,984.36
|
| Rate for Payer: Quartz Medicare Advantage |
$3,322.90
|
| Rate for Payer: The Alliance Commercial |
$13,291.62
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,322.90
|
| Rate for Payer: United Healthcare PPO |
$4,267.12
|
| Rate for Payer: Wellcare Medicare |
$3,322.90
|
|
|
Stachybotrys chartarum/atra IgE
|
Professional
|
Both
|
$103.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
6149788
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.43 |
| Max. Negotiated Rate |
$101.76 |
| Rate for Payer: Aetna Commercial |
$101.76
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$92.12
|
| Rate for Payer: Aetna Managed Medicare |
$5.43
|
| Rate for Payer: Anthem Medicare Advantage |
$5.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5.43
|
| Rate for Payer: Cash Price |
$30.90
|
| Rate for Payer: Cash Price |
$30.90
|
| Rate for Payer: Cigna Commercial |
$101.76
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$53.56
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5.43
|
| Rate for Payer: Health EOS Commercial |
$97.48
|
| Rate for Payer: HFN Commercial |
$101.76
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$19.17
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$19.17
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5.43
|
| Rate for Payer: Multiplan Commercial |
$85.70
|
| Rate for Payer: NAPHCARE Commercial |
$8.14
|
| Rate for Payer: Preferred Network Access Commercial |
$101.76
|
| Rate for Payer: Quartz Beloit One Network |
$47.13
|
| Rate for Payer: Quartz Commercial |
$61.06
|
| Rate for Payer: Quartz Medicare Advantage |
$5.43
|
| Rate for Payer: The Alliance Commercial |
$21.44
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.43
|
| Rate for Payer: WEA Trust Commercial |
$58.92
|
| Rate for Payer: WPS Commercial |
$23.89
|
|
|
Stachybotrys chartarum/atra IgE
|
Facility
|
OP
|
$103.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
6149788
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.43 |
| Max. Negotiated Rate |
$98.55 |
| Rate for Payer: Aetna Commercial |
$96.41
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$92.12
|
| Rate for Payer: Aetna Managed Medicare |
$5.43
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$20.36
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$9.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$9.01
|
| Rate for Payer: Anthem Medicare Advantage |
$5.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$56.77
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5.43
|
| Rate for Payer: Cash Price |
$30.90
|
| Rate for Payer: Cash Price |
$30.90
|
| Rate for Payer: Cigna Commercial |
$98.55
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$5.43
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$59.95
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$5.43
|
| Rate for Payer: Health EOS Commercial |
$95.34
|
| Rate for Payer: HFN Commercial |
$98.55
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$20.20
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$5.43
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5.43
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$5.43
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$5.43
|
| Rate for Payer: Multiplan Commercial |
$85.70
|
| Rate for Payer: NAPHCARE Commercial |
$8.14
|
| Rate for Payer: Preferred Network Access Commercial |
$98.55
|
| Rate for Payer: Quartz Beloit One Network |
$52.49
|
| Rate for Payer: Quartz Commercial |
$69.63
|
| Rate for Payer: Quartz Medicare Advantage |
$5.43
|
| Rate for Payer: The Alliance Commercial |
$21.72
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.43
|
| Rate for Payer: United Healthcare PPO |
$80.34
|
| Rate for Payer: WEA Trust Commercial |
$58.92
|
| Rate for Payer: Wellcare Medicare |
$5.43
|
| Rate for Payer: WPS Commercial |
$79.34
|
|
|
Stachybotrys chartarum/atra IgE
|
Facility
|
IP
|
$103.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
6149788
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$52.49 |
| Max. Negotiated Rate |
$98.55 |
| Rate for Payer: Aetna Commercial |
$96.41
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$92.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$56.77
|
| Rate for Payer: Cash Price |
$30.90
|
| Rate for Payer: Cigna Commercial |
$98.55
|
| Rate for Payer: Health EOS Commercial |
$95.34
|
| Rate for Payer: HFN Commercial |
$98.55
|
| Rate for Payer: Multiplan Commercial |
$85.70
|
| Rate for Payer: Preferred Network Access Commercial |
$98.55
|
| Rate for Payer: Quartz Beloit One Network |
$52.49
|
| Rate for Payer: Quartz Commercial |
$64.27
|
| Rate for Payer: WEA Trust Commercial |
$58.92
|
| Rate for Payer: WPS Commercial |
$79.34
|
|
|
Stachybotrys chartarum/atra IgG
|
Professional
|
Both
|
$103.00
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
6149789
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$8.13 |
| Max. Negotiated Rate |
$101.76 |
| Rate for Payer: Aetna Commercial |
$101.76
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$92.12
|
| Rate for Payer: Aetna Managed Medicare |
$8.13
|
| Rate for Payer: Anthem Medicare Advantage |
$8.13
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$8.13
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$8.13
|
| Rate for Payer: Cash Price |
$30.90
|
| Rate for Payer: Cash Price |
$30.90
|
| Rate for Payer: Cigna Commercial |
$101.76
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$53.56
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$8.13
|
| Rate for Payer: Health EOS Commercial |
$97.48
|
| Rate for Payer: HFN Commercial |
$101.76
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$28.70
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$28.70
|
| Rate for Payer: Independent Care Health Plan Medicare |
$8.13
|
| Rate for Payer: Multiplan Commercial |
$85.70
|
| Rate for Payer: NAPHCARE Commercial |
$12.20
|
| Rate for Payer: Preferred Network Access Commercial |
$101.76
|
| Rate for Payer: Quartz Beloit One Network |
$47.13
|
| Rate for Payer: Quartz Commercial |
$61.06
|
| Rate for Payer: Quartz Medicare Advantage |
$8.13
|
| Rate for Payer: The Alliance Commercial |
$32.12
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8.13
|
| Rate for Payer: WEA Trust Commercial |
$58.92
|
| Rate for Payer: WPS Commercial |
$35.78
|
|
|
Stachybotrys chartarum/atra IgG
|
Facility
|
IP
|
$103.00
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
6149789
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$52.49 |
| Max. Negotiated Rate |
$98.55 |
| Rate for Payer: Aetna Commercial |
$96.41
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$92.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$56.77
|
| Rate for Payer: Cash Price |
$30.90
|
| Rate for Payer: Cigna Commercial |
$98.55
|
| Rate for Payer: Health EOS Commercial |
$95.34
|
| Rate for Payer: HFN Commercial |
$98.55
|
| Rate for Payer: Multiplan Commercial |
$85.70
|
| Rate for Payer: Preferred Network Access Commercial |
$98.55
|
| Rate for Payer: Quartz Beloit One Network |
$52.49
|
| Rate for Payer: Quartz Commercial |
$64.27
|
| Rate for Payer: WEA Trust Commercial |
$58.92
|
| Rate for Payer: WPS Commercial |
$79.34
|
|
|
Stachybotrys chartarum/atra IgG
|
Facility
|
OP
|
$103.00
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
6149789
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$8.13 |
| Max. Negotiated Rate |
$98.55 |
| Rate for Payer: Aetna Commercial |
$96.41
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$92.12
|
| Rate for Payer: Aetna Managed Medicare |
$8.13
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$30.50
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$14.23
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$13.50
|
| Rate for Payer: Anthem Medicare Advantage |
$8.13
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$56.77
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$8.13
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$8.13
|
| Rate for Payer: Cash Price |
$30.90
|
| Rate for Payer: Cash Price |
$30.90
|
| Rate for Payer: Cigna Commercial |
$98.55
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$8.13
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$59.95
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$8.13
|
| Rate for Payer: Health EOS Commercial |
$95.34
|
| Rate for Payer: HFN Commercial |
$98.55
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$30.25
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$8.13
|
| Rate for Payer: Independent Care Health Plan Medicare |
$8.13
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$8.13
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$8.13
|
| Rate for Payer: Multiplan Commercial |
$85.70
|
| Rate for Payer: NAPHCARE Commercial |
$12.20
|
| Rate for Payer: Preferred Network Access Commercial |
$98.55
|
| Rate for Payer: Quartz Beloit One Network |
$52.49
|
| Rate for Payer: Quartz Commercial |
$69.63
|
| Rate for Payer: Quartz Medicare Advantage |
$8.13
|
| Rate for Payer: The Alliance Commercial |
$32.53
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8.13
|
| Rate for Payer: United Healthcare PPO |
$80.34
|
| Rate for Payer: WEA Trust Commercial |
$58.92
|
| Rate for Payer: Wellcare Medicare |
$8.13
|
| Rate for Payer: WPS Commercial |
$79.34
|
|
|
Stachybotrys IgA
|
Facility
|
IP
|
$67.00
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
5546930
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$34.14 |
| Max. Negotiated Rate |
$64.11 |
| Rate for Payer: Aetna Commercial |
$62.71
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$59.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$36.93
|
| Rate for Payer: Cash Price |
$20.10
|
| Rate for Payer: Cigna Commercial |
$64.11
|
| Rate for Payer: Health EOS Commercial |
$62.02
|
| Rate for Payer: HFN Commercial |
$64.11
|
| Rate for Payer: Multiplan Commercial |
$55.74
|
| Rate for Payer: Preferred Network Access Commercial |
$64.11
|
| Rate for Payer: Quartz Beloit One Network |
$34.14
|
| Rate for Payer: Quartz Commercial |
$41.81
|
| Rate for Payer: WEA Trust Commercial |
$38.32
|
| Rate for Payer: WPS Commercial |
$51.61
|
|
|
Stachybotrys IgA
|
Facility
|
OP
|
$67.00
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
5546930
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$17.96 |
| Max. Negotiated Rate |
$71.84 |
| Rate for Payer: Aetna Commercial |
$62.71
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$59.92
|
| Rate for Payer: Aetna Managed Medicare |
$17.96
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$67.35
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$31.43
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$29.81
|
| Rate for Payer: Anthem Medicare Advantage |
$17.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$36.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$17.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$17.96
|
| Rate for Payer: Cash Price |
$20.10
|
| Rate for Payer: Cash Price |
$20.10
|
| Rate for Payer: Cigna Commercial |
$64.11
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$17.96
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$38.99
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$17.96
|
| Rate for Payer: Health EOS Commercial |
$62.02
|
| Rate for Payer: HFN Commercial |
$64.11
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$66.81
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$17.96
|
| Rate for Payer: Independent Care Health Plan Medicare |
$17.96
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$17.96
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$17.96
|
| Rate for Payer: Multiplan Commercial |
$55.74
|
| Rate for Payer: NAPHCARE Commercial |
$26.94
|
| Rate for Payer: Preferred Network Access Commercial |
$64.11
|
| Rate for Payer: Quartz Beloit One Network |
$34.14
|
| Rate for Payer: Quartz Commercial |
$45.29
|
| Rate for Payer: Quartz Medicare Advantage |
$17.96
|
| Rate for Payer: The Alliance Commercial |
$71.84
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17.96
|
| Rate for Payer: United Healthcare PPO |
$52.26
|
| Rate for Payer: WEA Trust Commercial |
$38.32
|
| Rate for Payer: Wellcare Medicare |
$17.96
|
| Rate for Payer: WPS Commercial |
$51.61
|
|
|
Stachybotrys IgA
|
Professional
|
Both
|
$67.00
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
5546930
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$17.96 |
| Max. Negotiated Rate |
$79.03 |
| Rate for Payer: Aetna Commercial |
$66.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$59.92
|
| Rate for Payer: Aetna Managed Medicare |
$17.96
|
| Rate for Payer: Anthem Medicare Advantage |
$17.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$17.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$17.96
|
| Rate for Payer: Cash Price |
$20.10
|
| Rate for Payer: Cash Price |
$20.10
|
| Rate for Payer: Cigna Commercial |
$66.20
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$34.84
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$17.96
|
| Rate for Payer: Health EOS Commercial |
$63.41
|
| Rate for Payer: HFN Commercial |
$66.20
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$63.40
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$63.40
|
| Rate for Payer: Independent Care Health Plan Medicare |
$17.96
|
| Rate for Payer: Multiplan Commercial |
$55.74
|
| Rate for Payer: NAPHCARE Commercial |
$26.94
|
| Rate for Payer: Preferred Network Access Commercial |
$66.20
|
| Rate for Payer: Quartz Beloit One Network |
$30.66
|
| Rate for Payer: Quartz Commercial |
$39.72
|
| Rate for Payer: Quartz Medicare Advantage |
$17.96
|
| Rate for Payer: The Alliance Commercial |
$70.95
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17.96
|
| Rate for Payer: WEA Trust Commercial |
$38.32
|
| Rate for Payer: WPS Commercial |
$79.03
|
|
|
Stachybotrys IgE
|
Facility
|
IP
|
$67.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
5546929
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$34.14 |
| Max. Negotiated Rate |
$64.11 |
| Rate for Payer: Aetna Commercial |
$62.71
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$59.92
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$36.93
|
| Rate for Payer: Cash Price |
$20.10
|
| Rate for Payer: Cigna Commercial |
$64.11
|
| Rate for Payer: Health EOS Commercial |
$62.02
|
| Rate for Payer: HFN Commercial |
$64.11
|
| Rate for Payer: Multiplan Commercial |
$55.74
|
| Rate for Payer: Preferred Network Access Commercial |
$64.11
|
| Rate for Payer: Quartz Beloit One Network |
$34.14
|
| Rate for Payer: Quartz Commercial |
$41.81
|
| Rate for Payer: WEA Trust Commercial |
$38.32
|
| Rate for Payer: WPS Commercial |
$51.61
|
|
|
Stachybotrys IgE
|
Facility
|
OP
|
$67.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
5546929
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.43 |
| Max. Negotiated Rate |
$64.11 |
| Rate for Payer: Aetna Commercial |
$62.71
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$59.92
|
| Rate for Payer: Aetna Managed Medicare |
$5.43
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$20.36
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$9.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$9.01
|
| Rate for Payer: Anthem Medicare Advantage |
$5.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$36.93
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5.43
|
| Rate for Payer: Cash Price |
$20.10
|
| Rate for Payer: Cash Price |
$20.10
|
| Rate for Payer: Cigna Commercial |
$64.11
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$5.43
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$38.99
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$5.43
|
| Rate for Payer: Health EOS Commercial |
$62.02
|
| Rate for Payer: HFN Commercial |
$64.11
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$20.20
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$5.43
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5.43
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$5.43
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$5.43
|
| Rate for Payer: Multiplan Commercial |
$55.74
|
| Rate for Payer: NAPHCARE Commercial |
$8.14
|
| Rate for Payer: Preferred Network Access Commercial |
$64.11
|
| Rate for Payer: Quartz Beloit One Network |
$34.14
|
| Rate for Payer: Quartz Commercial |
$45.29
|
| Rate for Payer: Quartz Medicare Advantage |
$5.43
|
| Rate for Payer: The Alliance Commercial |
$21.72
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.43
|
| Rate for Payer: United Healthcare PPO |
$52.26
|
| Rate for Payer: WEA Trust Commercial |
$38.32
|
| Rate for Payer: Wellcare Medicare |
$5.43
|
| Rate for Payer: WPS Commercial |
$51.61
|
|
|
Stachybotrys IgE
|
Professional
|
Both
|
$67.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
5546929
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.43 |
| Max. Negotiated Rate |
$66.20 |
| Rate for Payer: Aetna Commercial |
$66.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$59.92
|
| Rate for Payer: Aetna Managed Medicare |
$5.43
|
| Rate for Payer: Anthem Medicare Advantage |
$5.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$5.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$5.43
|
| Rate for Payer: Cash Price |
$20.10
|
| Rate for Payer: Cash Price |
$20.10
|
| Rate for Payer: Cigna Commercial |
$66.20
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$34.84
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$5.43
|
| Rate for Payer: Health EOS Commercial |
$63.41
|
| Rate for Payer: HFN Commercial |
$66.20
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$19.17
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$19.17
|
| Rate for Payer: Independent Care Health Plan Medicare |
$5.43
|
| Rate for Payer: Multiplan Commercial |
$55.74
|
| Rate for Payer: NAPHCARE Commercial |
$8.14
|
| Rate for Payer: Preferred Network Access Commercial |
$66.20
|
| Rate for Payer: Quartz Beloit One Network |
$30.66
|
| Rate for Payer: Quartz Commercial |
$39.72
|
| Rate for Payer: Quartz Medicare Advantage |
$5.43
|
| Rate for Payer: The Alliance Commercial |
$21.44
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.43
|
| Rate for Payer: WEA Trust Commercial |
$38.32
|
| Rate for Payer: WPS Commercial |
$23.89
|
|
